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Natalia Paulina Quiroz-Casian, Juan Carlos Serna-Ojeda, Victor Manuel Bautista, Arturo J Ramirez-Miranda, Enrique O Graue-Hernandez, Diana Ponce Angulo; Clinical characteristics of fungal keratitis in a single referral center in Mexico City. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4798.
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© ARVO (1962-2015); The Authors (2016-present)
To describe etiology, clinical characteristics, risk factors, treatment and main outcomes of confirmed fungal keratitis in a single referral center in Mexico City.
Retrospective review of clinical and microbiology records of culture-proven fungal keratitis patients diagnosed between January 2013 through August 2016 were analyzed. The data included demographic and clinical characteristics, medical history, best-corrected visual acuity (BCVA) at presentation and resolution of the keratitis, etiology, initial therapy, medical and surgical treatments and complications. Different variables were analyzed through a multiple logistic regression software.
We included 52 patients (18 female and 34 male) with a mean age of 43 years (range 10 to 80 years) and a mean follow up of 5 months. The most common systemic comorbidity was Diabetes Mellitus (33%). Trauma was the most common predisposing factor (33%).Mean Initial and final BCVA was 3.0 logMAR[CS1] . Fusarium was the major fungal organism isolated (60%). Concomitant bacterial infection was present in 10 cases (19%). The most common presenting symptoms were pain (84%) and low vision (73%). The most common localization of ulcer was central (78%). Regarding treatment, the majority of patients received topical antifungal (mostly 0.5% natamycin) and oral itraconazole (100mg bid) and 30 patients (58%) required surgical intervention. Patients with history of previous topical steroids were more likely to require surgery (p=0.04).
Fungal keratitis represents an important cause of ocular morbidity and vision loss. To achieve significantly better clinical, microbiological and visual outcomes, an appropriate and early treatment should be administered when there is clinical suspicion of fungal keratitis, to prevent corneal blindness.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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